i don't think small talk is necessary- in fact lots of people dislike it. what's probably more important is that you express being comfortable through your body language and tone of voice when you do speak. your comfortable "vibes" will rub off on them.
I've been in my job now for 5 years and because of that I am very familiar to alot of people. This can be a good thing because most of the drivers who come in for load sheets or change always say hello and some do chat. I'm happy to talk to them often just listening and nodding! When I do speak I do tend to domonate the conversation and often find that I only want to listen to people telling me a funny story or something about what they are doing or have done. I often sell tickets to over 200 people a day, most don't have English as their first language. I see it as my job to get the facts from them and get them where they want to be the quickest way. I use my experience to get me through it. To be completely honest my best days are when the 'fun' 'happy' people are in because we help each other through the day. The worst are the 'moaners', the people who moan about the people and the job and anything else they can think of. It's true aspects of my job cause me problems but thats between me and the managers. Its not an issue my collegues or my customers should be effected by. This is why I try to keep smiling. Once you have got more experience of dealing with your patients it will become easier, but experience can can take along time and be hard work to gain. My only real issue with my job is the effect the erratic hours have on my health and spare time.